Healthcare Provider Details

I. General information

NPI: 1558325936
Provider Name (Legal Business Name): DANIEL ROBERT VALERIA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 09/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 E. ALGONQUIN RD
ALGONQUIN IL
60102
US

IV. Provider business mailing address

4041 GEORGETOWN CIR
ALGONQUIN IL
60102-6207
US

V. Phone/Fax

Practice location:
  • Phone: 847-658-3660
  • Fax: 847-658-5418
Mailing address:
  • Phone: 847-658-3660
  • Fax: 847-658-5418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: